tbuckley/cabot-search huggingface dataset:
AB0655 PREVALENCE AND RISK FACTORS ASSOCIATED WITH THROMBOCYTOPENIA IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AT HOSPITAL DEL MAR
Authors: J. Cornudella Lema, I. Carrión Barberà, F. Garacia Pallarols, B. Sánchez González, T. C. Salman Monte
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic Lupus Erythematosus (SLE) is an autoimmune disease with a variety of manifestations, one of which is immune thrombocytopenia (ITP). Immune thrombocytopenia has been reported in 7-40% of SLE patients [1,2]. <h3>Objectives</h3> To determine the prevalence of ITP in SLE patients and identify risk factors that correlate with ITP. <h3>Methods</h3> Retrospective case-control study. 407 medical records of SLE patients were reviewed: 34 patients were diagnosed with ITP (cases) and were age- and sex-matched with 2 controls with SLE without ITP. Differences between cases and controls were analysed as well as factors associated with ITP. <h3>Results</h3> ITP prevalence in our cohort was 8.35% and was diagnosed at age 43.35±17.70 years (mean±st dev). No significant differences were found in demographic variables. At lupus diagnosis, controls had a higher prevalence of arthritis (p-val= 0.02), while cases presented a higher proportion of haemolytic anaemia (p-val=0.04). Along SLE disease, cases had higher antiphospholipid syndrome (APS) antibodies (lupus anticoagulant, p-val=0.01; anti-cardiolipin, p-val=0.044, anti-β2GP1, p-val=0.003). Cases presented a significantly higher SLICC than controls (p-val=0.02). Regarding treatments, cases received mycophenolate (p-val=0.02) and azathioprine (p-val=0.045) more frequently than controls. <h3>Conclusion</h3> Patients with SLE that develop ITP seem to have a different phenotype than those without ITP, presenting less arthritis and more haemolytic anaemia at SLE disease onset, and more APS syndrome and APS antibodies along the disease. In addition, ITP was associated with a higher SLICC and with more frequent use of mycophenolate and azathioprine, possibly indicating a more severe disease, which would warrant the need of a more careful follow-up on these patients in the patients with the previously described associated characteristics. <h3>References</h3> [1]Velo-García et al. (2016). The diagnosis and management of the haematologic manifestations of lupus. Journal of autoimmunity, 74, 139–160. [2]Chen, Z. et al. (2019). Thrombocytopenia as a Prognostic Marker for Systemic Lupus Erythematosus: A Systematic Review and Meta-analysis. The American journal of the medical sciences, 357(6), 461–467. <h3>Disclosure of Interests</h3> None declared
AB0650 PREVALENCE OF FATIGUE AND ITS IMPACT ON QUALITY OF LIFE IN THE PATIENTS WITH PRIMARY SJOGREN’S SYNDROME
Authors: D. Das, G. Naidu, S. Grover, V. Dhir, S. K. Sharma, A. Sharma, S. Jain, P. Deo
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Among the extra-glandular symptoms in primary sjogren's syndrome (pSS), fatigue and pain are the most common. Fatigue is a poorly understood phenomenon with multi-faceted involvement. Therefore, it is important to assess the severity of fatigue and describe its various dimensions while assessing fatigue. On the other hand, fatigue is also one of the predictors of reduced health and quality of life in pSS. <h3>Objectives</h3> To assess fatigue by Fatigue Severity Scale (FSS) and Profile of fatigue (ProF) questionnaires and quality of life (QoL) with Health Assessment Questionnaire- Disability Index (HAQ-DI) and to know the association between the two in patients with pSS. <h3>Methods</h3> Patients fulfilling AECG 2002 and/or ACR-EULAR 2016 classification criteria for pSS were included in this prospective observational study between January 2021 to June 2022. Fatigue was assessed with FSS and ProF and QoL was assessed with HAQ-DI. Depression and somatoform disorder were assessed using PHQ9 and PHQ15 respectively. Associations with fatigue was compared using multivariate regression analysis. Written informed consent was obtained from all subjects included in the study and the study was approved by Institute Ethics Committee. <h3>Results</h3> Out of 125 patients, 114 (91.2%) were female and 11 (8.8%) were male with a female to male ratio of 9.6: 1. The median age at the time of inclusion into the study was 41(32-50) years. The median duration of the disease was 36 (12-60) months. The median ESSDAI and ESSPRI score were 2 (1-3) and 6 (2-9) respectively. Fifty seven (45.6%) patients had fatigue, defined as FSS of ≥4 and/ or ProF ≥2 in either of the domains. Among the patients with fatigue, 12 (21%) patients scored less than 4 on FSS, 36 (63.1%) had mild fatigue, 7 (12.2%) had moderate fatigue and only 2 (3.5%) patients had severe fatigue. The mean FSS score in the cohort was 2.9 ± 1.5. The ProF mean scores were 2.7 ± 0.6 for somatic fatigue and 2.9 ± 1.3 for mental fatigue. The median HAQ-DI in patients with fatigue was significantly more compared to non-fatigue patients (0.1 vs 0.5; p &lt;0.001; Figure 1). There was a positive correlation between fatigue score and HAQ-DI score (rpb = 0.36, n = 125, p = &lt;0.001). The prevalence of depression and somatoform disorder were 15.2% and 28% respectively. The ESSPRI pain score, ProFAD Ocular &amp; Oral dryness score and PHQ-9 score were positively associated with higher fatigue score. <h3>Conclusion</h3> Fatigue was seen in nearly half of the patients with pSS and patients with fatigue had impaired QoL as assessed by HAQ-DI. The pain, dryness and presence of depression are the predictors of fatigue in patients with pSS. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0559 EFFICACY AND SAFETY OF RITUXIMAB IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Y. Ren, L. Wang, Z. An, L. Yang, Q. Y. Su, Q. Yu, P. F. He, X. LI, S. X. Zhang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multisystem involvement characterized by the production of multiple autoantibodies and the consumption of complements. Rituximab, a chimeric anti-CD20 antibody, was already approved for treating B-cell lymphoma and autoimmune diseases. <h3>Objectives</h3> This study aimed to systematically evaluate the efficacy and safety of rituximab in treating SLE. <h3>Methods</h3> We systematically searched PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, FDA.gov, Clinical trials.gov, Wanfang database, and Weipu database (from database inception to January 1, 2023) for studies of rituximab in the treatment of SLE. Observational studies, case series, and randomized controlled trials reporting the efficacy or safety data on SLE treated with rituximab were included in this meta-analysis. We selected the effect model according to the heterogeneity of the meta-analysis. If I2 &lt; 50, a fixed effect model was used. <h3>Results</h3> A total of 8 studies with a total of 353 patients were included. After treatment with rituximab, the SLEDAI scores were significantly decreased [SMD=2.289, 95%CI (1.411,3.167), I2=64.5%, p&lt;0.001]. Four studies mentioned clinical responses, 91.9% of patients with SLE who received rituximab had distinct clinical remission compared with 72.1% of patients with SLE who received conventional medication. The incidence of adverse events was 7.61% and 21.83%, in which pulmonary infection and gastrointestinal disease were the most common events, and no serious adverse events were reported among all these studies. Besides, we observed not only remarkable increases in complement C3 and C4 after rituximab injection [SMD=-0.838, 95%CI (-1.099,-0.577), I2=0.0%, p&lt;0.001; SMD=-0.811, 95%CI(-1.071,-0.550), I2=0.0%, p&lt;0.001], but also significant decreases in IgA and IgG [SMD=1.372, 95%CI (0.322,2.422), I2=95.5%, p=0.010; SMD=1.102, 95%CI(0.102,2.103), I2=93.6%, p&lt;0.05],while there were no statistical differences in the ESR and IgM between before and after rituximab treatment (p&gt;0.05)(Figure 1). <h3>Conclusion</h3> Rituximab was effective and well-tolerated for the treatment of SLE, which had a low incidence of adverse events. <h3>Reference</h3> [1]Wise LM, Stohl W. Belimumab and Rituximab in Systemic Lupus Erythematosus: A Tale of Two B Cell-Targeting Agents. Front Med (Lausanne). 2020 Jun 30;7:303. doi: 10.3389/fmed.2020.00303. PMID: 32695790; PMCID: PMC7338653. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0570 RELATIONSHIPS AMONG ANXIETY, DEPRESSION AND DESEASE ACTIVITY IN ASIANS SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS FROM KAZAKHSTAN AND KIRGHIZSTAN
Authors: B. Issayeva, G. Koilubaeva, E. Aseeva, N. Nikishina, A. Mesnyankina, S. Solovyev, S. Issayeva, M. Bizhanova
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Depression and anxiety cause severe loss of quality of life for patients with systemic lupus erythematosus. The causes and factors that contribute to these psychological manifestations in lupus are difficult to disentangle. <h3>Objectives</h3> The aim of this study was to determine factors associated with anxiety and depression in Asians systemic lupus erythematosus patients (pts) from Kazakhstan and Kirghizstan. <h3>Methods</h3> 1060 SLE pts who fulfilled SLICC 2012 criteria were enrolled into the study. The SLEDAI 2K index activity, SLICC damage index, depressive and anxiety symptoms were assessed by the Hospital Anxiety and Depression (HAD) scale (0-21 points). <h3>Results</h3> 1060 Lupus pts were studied, respectively. The pts were predominantly female (92%) and of indigenous nationality (Kazakh 10%,/ Kirghiz 54%/Russian 36%)with a mean±SD age 34,6±11,8 years. The mean disease duration (Мe) was 4 [1;9], the disease activity (SLEDAI 2K) 13,23±8,74, SLICC damage index 1,36±0,82. More than half of the pts (619 [58.3%]) had abnormal points by HADS scale. 1060 pts were divided into two groups. The first group included 619 SLE pts with abnormal HADS (HADS-A ≥ 8 points; HADS-D ≥ 8 points; HADS-D ≥ 8 points and HADS-A ≥ 8 points). The second one included 441 SLE pts with normal HADS. The most common were anxiety and depression (HADS-D ≥ 8 points and HADS-T ≥ 8 points) - in 346 (32.6%) pts, the second most common was anxiety disorder (HADS-T ≥ 8 points) - in 230 (22%) pts, the third - depressive disorder (HADS-D ≥ 8 points) - in 43 (4%). Such factors as age of the pts, age of SLE onset, duration of illness, SLICC damage index, SLEDAI 2 К, and dosage of corticosteroids. The pts with abnormal HADS were older (36,04±12,11 versus 29,94±11,49 years; p=0,003), with less disease duration (3,1 [0,9;8] versus 4,7 [1,5; 10]; p=0,01), with disease onset at a more later age (31,55±11,86 versus 26,43±11,39 years; p=0,0002), with higher SLE activity by SLEDAI 2 K (14,78±8,59 versus 12,22±8,30; p=0,01). The pts with abnormal HADS were treated with higher doses of glucocorticoids (22,33±12,6 versus 18,5±12,0 mg per day; p=0,005). <h3>Conclusion</h3> Depressive and anxiety symptoms are common (58,3%) in SLE pts and significantly higher among Asians pts (46%). Such factors as pts age, age of SLE onset, duration of illness, SLEDAI 2 К, and dosage of corticosteroids were strongly associated with abnormal HADS. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0443 REAL-WORLD EXPERIENCE OF BIOSIMILAR RITUXIMAB GP2013 IN RHEUMATOID ARTHRITIS PATIENTS NAÏVE TO OR SWITCHED FROM REFERENCE RITUXIMAB
Authors: K. Łosińska, M. Korkosz, A. H. Pripp, G. Haugeberg
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Randomized controlled trials showed high comparability of biosimilar rituximab (bs-RTX) GP2013 to biologic originator RTX (bo-RTX) in terms of physicochemical and functional properties, pharmacokinetics, efficacy and safety [1,2]. Data on effectiveness of switching from bo-RTX to bs-RTX, starting therapy with bs-RTX and bs-RTX drug survival in real-world setting is sparse. <h3>Objectives</h3> To explore long-term drug effectiveness and survival of bs-RTX GP2013 in rheumatoid arthritis (RA) patients both naïve to and mandatory switched from bo-RTX in ordinary outpatient clinic. <h3>Methods</h3> Retrospective observational cohort study including adult RA patients treated with bs-RTX between 2018 and 2021 in Norway. Patients were examined and monitored with recommended disease activity measures and patient-reported outcomes (PROs). Drug survival was assessed with Kaplan-Meier survival analysis. <h3>Results</h3> 110 RA patients (71.8% women) treated with bs-RTX were identified (88 mandatory switched from bo-RTX, 22 RTX-naïve), baseline median (IQR) age was 68.0 (59.0-76.0) years, disease duration 13.0 (7.4-18.7) years, 93.6% were RF and 96.3% ACPA positive, 30.0% currently used csDMARDs (26.4% methotrexate). Statistically significant difference between bs-RTX-naïve and bs-RTX-switched patients was found for disease duration (3.0 vs 14.2 years, p&lt;0.01), current steroids use (68.2% vs 35.2%, p=0.01) and first cycle bs-RTX dose: 90.9% bs-RTX-naïve received 2000 mg, while 85.3% bs-RTX-switched 1000 mg or 500 mg. During 2-year follow-up disease activity and PROs measures remained stable in switchers and improved in those starting naïve on RTX (Table 1). Overall drug survival for bs-RTX was 80.0% (95% CI 71.2-86.3%) after 1 year and 57.7% (95% CI 47.8-66.3%) after 2 years. Drug survival in bs-RTX-switched patients was significantly higher than in bs-RTX-naïve (Figure 1). <h3>Conclusion</h3> For the first time real-life data on drug effectiveness for GP2013 bs-RTX in RA is presented. Non-medical switch to bs-RTX is largely effective, no deterioration in disease activity outcomes was observed. Response in RTX-naïve patients was satisfactory and effect remains stable after 2-year follow-up. Drug survival was similar to published data for originator RTX. <h3>References</h3> [1]Smolen JS et al. A randomized, double-blind trial to demonstrate bioequivalence of GP2013 and reference rituximab combined with methotrexate in patients with active rheumatoid arthritis. <i>ARD</i>. 2017;76:1598-1602 [2]Smolen JS et al. Efficacy and safety of Sandoz biosimilar rituximab for active rheumatoid arthritis: 52-week results from the randomized controlled ASSIST-RA trial. <i>Rheumatology</i>. 2021;60:256-262 <h3>Acknowledgements</h3> Nurses and doctors from Division of Rheumatology at Sørlandet Hospital in Kristiansand, Norway contributed to data collection. <h3>Disclosure of Interests</h3> None Declared.
AB0507 FILGOTINIB MAY BE USEFUL THERAPY FOR RAPID RADIOGRAPHIC PROGRESSION BY REDUCING BONE EDEMA
Authors: K. Katayama, K. Tanaka, T. Kawahata, M. Yuichi, T. Okubo, T. Sato, S. Abe, H. Ito
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Filgotinib is well-known to inhibit bone destruction in patients with RA, particularly those with poor prognostic factors. Recently, Filgotinib, especially at dose 200mg/d has been reported to have good results to inhibiting joint damage in patients with rapid radiographic progression (RRP) condition compared to non-RRP condition in post-hoc study of Finch1(Methotrexate (MTX) iR) or Finch 3(MTX naive) trial [1]. However, little has been reported about the joint protective activity by Filgotinib in the real world. On the other hand, we previously demonstrated that extensive MRI bone edema (BE) in the hand is a prognostic factor for RRP [2]. <h3>Objectives</h3> To clarify, filgotinib action for inhibiting RRP, 10 patients who have extensive BE in hands or feet are analyzed for radiographic study for joint destruction from 32 patients treated with Filgotinib+MTX. <h3>Methods</h3> All 32 patients with inadequate response to MTX/Biologics/JAKi who were treated with filgotinib were examined to check for extensive BE in their most painful joints before treatment by MRI(Canon,1.5T). Blood examination, DAS28-ESR, patient pain and doctor's VAS, mHAQ were routinely examined. <h3>Results</h3> As shown in Table 1, most of the patients were treated with filgotinib 200mg/d +MTX. Patients 1-4 (12 months) and patients 5,6 (2-3 months) had extensive BE in hand and RRP condition at baseline. Finally, the RRPs in all patients improved and BE almost disappeared (patients 1,2). Especially, patient 5 suffered severe BE and RRP during 4 months who was treated with IL-6inhibitor +MTX6mg/w, are tremendously recovering by filgotinib and denosumab (for osteoporosis) from severe joint damage (Figure 1). Patients 7-10 had extensive BE in mid-tarsal (2), toe (1), shoulder (1) and patients 7-9 had disappeared BE and symptoms and patient 10 had disappeared pain (not MRI checked). Finally, most of the patients showed clinical improvement (DAS28-ESR, VAS,HAQ). <h3>Conclusion</h3> Filgotinib (200mg/d)+MTX may be useful therapy for RRP by reducing BE. <h3>References</h3> [1]Tanaka.Y, Rheumatoid Ther. 2022 [2]<b>Katayama.K, ARD,supple SAT0100,2014</b> <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0492 ANEMIA IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH JAK INHIBITORS
Authors: Y. Takeuchi, M. Konishi, H. Hirabayashi, M. Tokuda
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Recently, the safety of JAK inhibitors in the treatment of rheumatoid arthritis(RA) about malignancy and major adverse cardiac events has been highlighted <sup>[1]</sup>, but there are still few reports on their effects on anemia. Filgotinib (FIL) is known to be a highly JAK1-selective agent with little effect on EPO-mediated JAK2 signaling <sup>[2]</sup>. <h3>Objectives</h3> We investigated the effect of FIL on anemia in RA patients treated with JAK inhibitors at our hospital, comparing with other JAK inhibitors (non-FIL). <h3>Methods</h3> 73 patients who used 4 JAK inhibitors (filgotinib, tofacitinib, baricitinib, upadacitinib) after 2013 were divided into FIL group (16 patients) and non-FIL group (57 patients) respectively. Hemoglobin (Hb) trends at 3 and 6 months after the start of JAK inhibitors were investigated retrospectively. Subsequently, the investigation was performed with propensity score matching by age, gender, baseline Hb, CRP, s-Cre, presence of anemia treatments, presence of corticosterids/DMARDs, and history of previous bDMARDs/JAK inhibitor use. And, among the FIL group, we also examined whether there was a difference in Hb change depending on the history of JAK inhibitor use. <h3>Results</h3> Hb levels at the baseline were 10.5 g/dl in the FIL group and 11.6 g/dl in the non-FIL group, but there was no significant difference. The patients in the FIL group were significantly more likely to have used bDMARDs, other JAK inhibitors, and anemia treatments on starting FIL. Both at 3 and 6 months, although Hb levels were significantly increased in the FIL group (P&lt;0.05), the anemia progressed over time in the non-FIL group despite exclusion of hemorrhagic anemia (Figures 1,2). The results after propensity score matching were also similar (P&lt;0.05). There were no differences in CRP or RA disease activity at 0, 3, and 6 months. And then, compared to the FIL group with no history of JAK inhibitor use, the group that switched to FIL as a 2nd JAK inhibitor showed a significant Hb increase (P&lt;0.05). <h3>Conclusion</h3> Compared to other JAK inhibitors, FIL did not reduce Hb levels and that could be maintained for a long time. In patients with anemia concerned with JAK inhibitors, switching to FIL is possible to make RA treatment safer and more successful. <h3>References</h3> [1]FDA Drug Safety Communication issued on February 4, 2021. [2]Traves PG, Murray B, Campigotto F, et al. JAK selectivity and the implications for clinical inhibition of pharmacodynamic cytokine signaling by filgotinib, upadacitinib, tofacitinib and baricitinib. Ann Rheum Dis. 2021; 80: 865-875. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0447 MEDICATION BELIEFS DURING THE PRECONCEPTION PERIOD AMONG PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: E. Hannech, H. Boussaa, S. Miladi, A. Fazaa, M. Yasmine, L. Souabni, K. Ouenniche, S. Kassab, S. Chekili, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Treatment maintenance in young women with rheumatoid arthritis (RA) may be influenced by factors such as fears of side effects on fertility and conception. <h3>Objectives</h3> We aimed to assess the therapeutic beliefs of patients with RA during the preconception period and to investigate associated factors. <h3>Methods</h3> We conducted a cross-sectional study including patients diagnosed with RA before menopause. We assessed beliefs about treatment during the preconception period using the French version of Beliefs about Medicines Questionnaire (BMQ). The questionnaire assessing specific beliefs is composed of 10 items: 5 items to assess beliefs regarding the necessity for treatment and 5 items to assess concerns. <h3>Results</h3> We included 31 females (mean age: 49.7±10.4 years). RA was erosive in 93% of cases. Coxitis was noted in 6 patients (19%) and atloido-axial dislocation in 2 patients (6%). The average number of gestation and parity was, respectively, 3 [0-9] and 2 [0-7]. Contraception was used by 20 patients (64%). The contraceptive method was progestin-only pill (10 patients), intrauterine device (6 patients), condoms (2 patients), and calendar method (2 patients). The mean beliefs' score regarding treatment necessity and concerns were 18.8±3.3 [10-23] and 12.3±5.9 [5-23], respectively. The score of therapeutic necessity was higher in patients without desire to conceive, but the difference was not significant (19.1±3.1 vs 17.2±4.8, p=0.246). The presence of erosions had an influence on therapeutic necessity (19±3 vs 16.5±7.7, p=0.03). The therapeutic necessity score was statistically higher in patients with coxitis (20.1±1.6 vs 18.5±3.6, p=0.05). The conception desire had no influence on concerns. The disease duration had a statistically negative correlation with concern score (r=-0.480, p=0.006). Contraception use was not influenced by either therapeutic necessity or concerns (p=0.129 and p=0.140, respectively). <h3>Conclusion</h3> This study showed that beliefs about therapeutic necessity during the preconception period were more important than concerns. We emphasize the importance of therapeutic patient education to fight against negative beliefs. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.